Pathogenesis and Consequences of the Alteration of Glucose Metabolism in Renal Insufficiency

Abstract

The decreased hyperglycemic response of patients in renal insufficiency (RI) to the applied glucagon or epinephrine and abnormal galactose tolerance test pointed to the abnormal liver glycogen metabolism and its decreased liver concentration (Cohen, 1962; Westervelt and Schreiner, 1962). However, later on the glucagon and epinephrine studies have not been confirmed and normal liver glycogen concentration was found in a group of patients with normal caloric intakte in our laboratory (Dzúrik and Brixová, 1968). The liver glycogen concentration was normal even in patients with abnormal glucose tolerance test. Similar findings were published on muscle glycogen by Bergström (Bergström and Hultman, 1969). It appears now that the glycogen concentration and metabolism depend primarily on nutritional state and not on renal insufficiency. Consequently, adequate caloric intake is the best prevention of this abnormality.